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1、FOLFOX方案在進展期胃癌新輔助化療中的應(yīng)用李國帥張成武*(青海大學(xué)附屬醫(yī)院胃腸外科810001;*通訊作者,張成武,主任醫(yī)師)胃癌是我國最常見的惡性腫瘤之一,早期發(fā)現(xiàn)較為網(wǎng)難。據(jù)統(tǒng)計,我國住院胃癌患者中,進展期占70%?80%[1],而且多伴有淋巴結(jié)轉(zhuǎn)移,手術(shù)仍然為其首選的治療方式。此類患者手術(shù)切除率低,獲得根治性切除的比例較少,5年生存率低,治療效果差。積極提高手術(shù)切除率成為改善胃癌患者預(yù)后的一大目標(biāo)。對于進展期胃癌術(shù)前行輔助化療有助于手術(shù)以及提高術(shù)后存活率、降低復(fù)發(fā)及轉(zhuǎn)移率。臨床上對于進展期胃癌
2、術(shù)前新輔助化療的方案多種多樣,但最常見的仍為FOLFOX方案(奧沙利鉑4■亞葉酸鈣+氟尿嘧啶)。該方案用于進展期胃癌新輔助化療有效率較高,不良反應(yīng)多為輕度,經(jīng)對癥處理后可緩解,未影響后續(xù)治療的進行和造成不可逆性損傷,能夠增加腫瘤完全切除的機會,提高手術(shù)效果[2]?!娟P(guān)鍵詞】進展期胃癌;新輔助化療;氟尿啼啶;亞葉酸鈣;奧沙利鉑【中圖分類號】R2【文獻標(biāo)號】A1671-8725(2014)11-0112-02ApplicationofFOLFOXneoadjuvantchemotherapyregimeni
3、nthetreatmentofadvancedgastriccarcinomaLiGuoshuai;ZhangChengwu(GastrointestinalsurgeryofAffiliatedHospitalofQinghaiUniversity810001;*correspondingauthor,ZhangChengwu,chiefphysician)abstract:Objective:Gastriccancerisoneofthemostcommonmalignanttumorinourco
4、untry,it'sdifficulttomakedetectionearly.HospitalizationinpatientswithgastriccancerinChina,thedevelopmentperiodisabout70%to80%,andmoreassociatedwithlymphnodemetastasis,surgeryisstillthefirstchoiceoftreatment.Patientswithsurgicalresectionrateislow,toobtain
5、theproportionoflessradicalexcision,5-yearsurvivalrateislow,thetreatmenteffectispoor.Activelyimprovetheresectionratebecomeabiggoalofimprovingtheprognosisofpatientswithgastriccancer.Foradvancedgastriccancerlinepreoperativeadjuvantchemotherapyhelpstoimprove
6、operationandpostoperativesurvivalrate,reducetherateofrecurrenceandmetastasis.Foradvancedgastriccancerclinicalpreoperativeneoadjuvantchemotherapyschemeisvaried,butthemostcommonisstillFOLFOXscheme.Theschemeisusedforadvancedgastriccancerneoadjuvantchemother
7、apyhighefficient,adversereactionsaremild,aftersymptomatictreatmentcanalleviate,didnotaffecttheproceedingofthefollow-uptreatmentandcauseirreversibledamage,increasesthechanceofcompletetumorexcision,improvetheeffectofsurgery.KeyWords:Advancedgastriccancer;N
8、eoadjuvantchemotherapy;5-Fluorouracil;Calciumfolinate;Oxaliplatin0前,經(jīng)確診的胃癌仍大多數(shù)為進展期胃癌,但進展期胃癌的手術(shù)效果遠(yuǎn)遠(yuǎn)差于旱期胃癌。手術(shù)切除是根治胃癌的唯一手段,而進展期胃癌通常由于對周圍組織的侵犯而不能進行根治性切除,從而造成了其復(fù)發(fā)率高和生存率低的狀態(tài)。因此,尋求提高進展期胃癌根治性切除率的手段具奮重要意義。胃癌新輔助化療又稱術(shù)前化療,其目的是降低腫瘤臨床分期